Association of Sex Hormones, Aging, and Atrial Fibrillation in Men: The Framingham Heart Study
Open accessAbstract
Background—: Endogenous sex hormones have been related to cardiovascular outcomes and mortality. We hypothesized that sex hormones are related to atrial fibrillation (AF) in a community-based cohort of middle-aged to older men. Methods and Results—: We examined testosterone, estradiol, and dehydroepiandrosterone sulfate in relation to incident AF in men participating in the Framingham Heart Study. We assessed the 10-year risk of AF in multivariable-adjusted hazard models. The cohort consisted of 1251 men (age, 68.0±8.2 years), of whom 275 developed incident AF. We identified a significant interaction between age and testosterone and, therefore, stratified men into age 55 to 69 years (n=786), 70 to 79 years (n=351), and ≥80 years (n=114). In men aged 55 to 69 years, each 1 SD decrease in testosterone was associated with hazard ratio (HR) 1.30 (95% confidence interval [CI], 1.07–1.59) for incident AF. The association between testosterone and 10-year incident AF in men 70 to 79 years did not reach statistical significance. In men ≥80 years, a 1 SD decrease in testosterone was associated with HR 3.53 (95% CI, 1.96–6.37) for AF risk. Estradiol was associated with incident AF (HR, 1.12; 95% CI, 1.01–1.26). Dehydroepiandrosterone sulfate had a borderline association with risk of AF that was not statistically significant (HR, 1.12; 95% CI, 0.99–1.28). Conclusions—: Testosterone and estradiol are associated with incident AF in a cohort of older men. Testosterone deficiency in men ≥80 years is strongly associated with AF risk. The clinical and electrophysiological mechanisms underlying the associations between sex hormones and AF in older men merit continued investigation.
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The bulk of studies evaluating sex differences in the AF-related risk of heart failure have showed no significant difference; however, a few studies have suggested higher risk in women.
“The bulk of studies evaluating sex differences in the AF-related risk of HF have showed no significant difference; however, a few studies have suggested higher risk in women (Supplementary Table S8).”
From Atrial fibrillation in women: epidemiology, pathophysiology, presentation, and prognosis (2016) · cites this paper as [103]
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Atrial fibrillation in women: epidemiology, pathophysiology, presentation, and prognosis
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Self-citation
- Authors
- Magnani, J. W., Moser, C. B., Murabito, J. M., Sullivan, L. M., Wang, N., Ellinor, P. T., Vasan, R. S., Benjamin, E. J., & Coviello, A. D.
- Affiliations
- Boston University (US)
- ORCID
- Venue
- Circulation: Arrhythmia and Electrophysiology
- Published
- 2014-04
- Volume
- 7
- Issue
- 2
- Pages
- 307-312
- ISSN
- 1941-3084 (ISSN-L)
- 1941-3149
- PMC
- PMC4035016
- OpenAlex
- W2151620605
- Cited by
- 112
- References
- 45
- Citations by year
- 2026: 8 · 2025: 9 · 2024: 10 · 2023: 10 · 2022: 13 · 2021: 9 · 2020: 9 · 2019: 10 · 2018: 13 · 2017: 10 · 2016: 5 · 2015: 3 · 2014: 3
- FWCI
- 4.81
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Circulation Arrhythmia and Electrophysiology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- American Heart Association (N01-HC-25195, HL092577, 1R01HL102214, 13EIA14220013)
- School of Medicine, Boston University (N01-HC25195)
- National Institutes of Health (1r03ag045075-01, n01hc025195-11-0-0, HL092577, N01-HC 25195)
- National Institute on Aging (R01-AG29451, R03-AG045075, R01AG029451, 1R03AG045075, R01AG028321)
- National Heart, Lung, and Blood Institute (N01‐HC25195, RC1-HL01056, R01HL104156, R01HL102214, N01-HC-025195, R01HL094755, HL092577, Z01HL001056, K24HL105780, R01HL092577)
- National Institute of Neurological Disorders and Stroke (6R01NS17950, R01NS017950)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Keywords
- atrial fibrillation, sex hormones, testosterone, estradiol, dehydroepiandrosterone sulfate, aging, older men, androgen deficiency, age-stratified risk, Framingham Heart Study
- MeSH terms
- Age Factors, Aged, Aged, 80 and over, Aging, Atrial Fibrillation, Follow-Up Studies, Humans, Male, Middle Aged, Prognosis, Prospective Studies, Radioimmunoassay, Risk Factors, Gonadal Steroid Hormones, Time Factors, United States, Biomarkers, Incidence, Survival Rate, Age Distribution, Risk Assessment
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